Individual
DR. JOHN EDWARD ITALIA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
318 TOFTREES AVE, APT 140, STATE COLLEGE, PA 16803-2031
(412) 974-6134
Mailing address
318 TOFTREES AVE, APT 140, STATE COLLEGE, PA 16803-2031
(412) 974-6134
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS 030-188L
PA
Other
Enumeration date
06/09/2005
Last updated
07/08/2007
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